Hospitals and healthcare systems are now fully engaged in the social networking phenomenon. Despite many healthcare systems’ historically risk averse cultural orientations, and their tendency to rely on the most authoritative sources for information, hospitals increasingly are breaking out of this mold with their use of social media. Many now depend on social networking sources, such as LinkedIn Groups, Facebook, and Twitter, to attract and assess candidates for employment, to enhance their brand, and to build employee and patient loyalty. This is perhaps no surprise, considering the studies that show that all age groups (including 60% of people age 55 and over, and a still higher percentage of all other age groups over 15) are comfortable with, and are regularly using, social media. The fastest growing segment of social network users are women between 35 and 64—a demographic that describes a significant percentage of healthcare decisionmakers.

Responding to this reality, hospitals and healthcare systems now regularly tout their success stories on YouTube; they use social networks to increase donations, education, and evangelism and to empower their employees, stakeholders, and advocates; and they sponsor groups that enable patients to easily spread the word about their experiences at the hospital. This year, several hundred healthcare systems used YouTube, Twitter, Facebook or blogging to interactively deliver messaging. Some established vibrant online communities where employees and patients regularly congregate and exchange ideas. Many captured newsworthy moments, provided health tips, or responded to requests for health information, by “tweeting” on Twitter. Hiring employers used LinkedIn Healthcare Groups to identify applicants and place targeted job advertisements. The most successful of these social network users identified the value of a strong partnership between their marketing and staffing functions, and plenty of hospitals quickly learned that their YouTube accounts and Facebook Groups were vastly more successful at branding important initiatives, and attracting traffic, than were their traditional websites. By developing tools that enable immediate interactions with patients and employees, several healthcare systems were uniquely poised to effectively respond, in real time, to what others were posting about them on the web.Before leaping into the fray, however, healthcare systems and hospitals are well-advised to develop a comprehensive strategy, and sound policies, to govern how social media should be appropriately used. After all, the risks associated with social networks are varied and can include such claims as discrimination and harassment, privacy and stored communications violations, negligence, defamation, intellectual property infringement, off-the-clock work by nonexempt employees, and violations of HIPAA or the National Labor Relations Act. As just one example, a hospital in the Southwest fired two employees who posted pictures of patients’ injuries on MySpace. The parties disputed whether the infraction identified the patients in a way that would constitute a HIPAA violation, but the hospital relied on a violation of its policy on cellphone use to support the termination and defend against invasion of privacy claims.

While three quarters of managers believe that social networking sites may put their brand or reputation at risk, less than twenty percent of employers have specific risk mitigation policies in place. For some organizations, operational considerations and management’s unwillingness to buy-in to social networking strategies may place hurdles in the path. But even in organizations where social networking tools are embraced, an entity’s ability to carefully control content and effectively manage distribution will dictate success. Hospitals should work with legal counsel to create and distribute policies that specifically address how social networking works within the hospital’s communications and other programs. These policies also should cover all aspects of the employment relationship: pre-employment considerations (such as antidiscrimination, because employers may gain access to information through social networks that would not otherwise be available from more traditional hiring tools); disciplinary issues during employment (such as prohibiting the posting of patient information, and mandating anti-harassment and respectful language); and post-employment considerations (such as whether to prohibit “recommendations” on LinkedIn, for example, to avoid inconsistent messaging regarding an employee terminated for performance reasons). Of course, all employers must define clear goals for their social media programs (including who they want to reach, why, and how they will measure success), and must incorporate specific training and monitoring programs to ensure their social networking policies are understood and enforced.

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